a person is guilty of assault of
(a/an) (elderly / blind / disabled / pregnant / intellectually disabled) person [with
a firearm] in the (first / second / third) degree when such person commits
assault [with a firearm] in the (first / second / third) degree and the person assaulted <insert as appropriate:>

is at least sixty
years of age.

is blind.

is physically
disabled.

is pregnant.

is intellectually disabled, and the actor is not a person with intellectually disability.

For you to find the defendant guilty
of this charge, the state must prove beyond a reasonable doubt the following
elements:

Element 1 - Committed assaultThe first element is that the
defendant committed assault [with a firearm] in the (first / second / third)
degree. <Insert elements from
instruction for the underlying crime:>

Element 2 - Status of
complainantThe second element is that
the person assaulted was, at the time, <insert
as appropriate:>

at least sixty
years of age. The defendant did not have to know that the person was over sixty years of age.

blind. For
purposes of this offense, a person is "blind" if (his/her) central visual acuity
does not exceed 20/200 in the better eye with correcting lenses, or if (his/her)
visual acuity is greater than 20/200 but is accompanied by a limitation in the
fields of vision such that the widest diameter of the visual field subtends an
angle no greater than twenty degrees.2
<Insert any medical evidence.> In addition, the defendant did not have to know that the person was blind.

physically
disabled. For purposes of this offense, a person is "physically disabled" if
(he/she) has any chronic physical handicap, infirmity or impairment, whether
congenital or resulting from bodily injury, organic process or changes or from
illness, including, but not limited to, epilepsy, deafness or hearing impairment
or reliance on a wheelchair or other remedial appliance or device. Thus, it
does not matter whether the person was born with the chronic physical handicap,
infirmity or impairment, or if it resulted from bodily injury, organic processes
or changes or illness.3
In addition, the defendant did not have to know that the person was physically disabled.

pregnant.

intellectually disabled, and the person committing the assault was not a person with
intellectual disability. For purposes of this offense, "intellectual disability" means a
significantly subaverage general intellectual functioning existing concurrently
with deficits in adaptive behavior and manifested during the developmental
period. "General intellectual functioning" means the results obtained by
assessment with one or more of the individually administered general
intelligence tests developed for that purpose and standardized on a
significantly adequate population and administered by persons formally trained
in test administration. "Significantly subaverage" means an intelligence
quotient more than two standard deviations below the mean test. "Adaptive
behavior" means the effectiveness or degree with which an individual meets the
standards of personal independence and social responsibility expected for the
individual's age and cultural group. "Developmental period" means the period of
time between birth and the eighteenth birthday.4
<Insert any evidence of general intellectual functioning and adaptive
behavior.>

[Affirmative defense

<Include
if raised by the defendant:>

The defendant has raised the
affirmative defense that (he/she), at the time of the incident, did not know
that <insert name of complainant> was (pregnant / intellectually disabled).

In summary, the state must prove
beyond a reasonable doubt that <insert the concluding summary from the
instruction for the underlying crime>, and that at the time of the assault,
<insert name of complainant> was (at least sixty years of age / blind /
physically disabled / pregnant / intellectually disabled).

<Insert one of the
following endings:>

If the defendant has not raised the affirmative
defenseIf you unanimously find that the state has proved
beyond a reasonable doubt each of the elements of the crime of assault of (a/an)
(elderly / blind / physically disabled / pregnant / intellectually disabled) person [with a
firearm] in the (first / second / third) degree, then you shall find the
defendant guilty. On the other hand, if you unanimously find that the state has
failed to prove beyond a reasonable doubt any of the elements, you shall then
find the defendant not guilty.

If the defendant has raised the affirmative defenseIf you unanimously find that the state has failed to
prove beyond a reasonable doubt any of the elements of the crime of assault of
(a pregnant / an intellectually disabled) person [with a firearm] in the (first / second /
third) degree, you shall then find the defendant not guilty and not consider
(his/her) affirmative defense.

If you unanimously find that the state has proved
beyond a reasonable doubt each of the elements, then you shall consider the
defendant's affirmative defense. If you unanimously find that the defendant has
proved by a preponderance of the evidence that (he/she) did not know that <insert
name of complainant> was (pregnant / intellectually disabled), then
you shall find the defendant not guilty. If you unanimously find that the
defendant has not proved (his/her) defense by a preponderance of the evidence,
then you shall find the defendant guilty.
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